Physical Therapist is Seeking your Thoughts and Experiences on Intervention for Acute Concussions

HiMy clinic has been hearing that doctors are referring patients with concussions for physical therapy. Is anyone out there doing rehab for concussions that is not just following a return to play per impact? I know PTs work with patients who develop post concussion syndrome but what is being done by PTs to rehabilitate concussions in the acute stages?Thanks!

8 Responses to Physical Therapist is Seeking your Thoughts and Experiences on Intervention for Acute Concussions

I would really appreciate hearing the answers. The course I went to said minimal stimulation for 2 weeks, no tv , no video games, and dim lighting…. Wonder if the PT is just supposed to educate the family and patients?? A second concussion is worse than the first.
Good luck,
Laura

I work with a concussion team that sends me primarily pediatric concussion patients often within 1-2 weeks of the injury. We do an exertional program that we have developed over the past year. I see the patietns that are dizzy. I find that autonamic dysfunciton and ocular motor dysfunciton are a large part of the problem. I have had great sucess with gentle manual therpay, convergence and smooth pursuit exercises as well as light core exercises as tolerated. In our concussion group the main doctor is a pediatric ER physican and we have worked closesly with cardiology and neurology to develop the program. There are several good articles out that can help. Leddy has published a few and the University of Pittsburg also has some information on acute rehab. I hope that helps.

This is question that is somewhat challenging to answer via text/blog. I would recommend looking at current research, access the APTA website – The learning center has a few lectures/continuuing education modules by experienced clinicians in this area that would be of benefit and the APTA listserv also may be of assist as there has been discussion on this topic there. Good Luck.

Not to be too controversial but I do not believe physical therapists in Washington can technically return an athlete to play after a concussion. As far as I know it has to be a physician or athletic trainer, although chiropractors are fighting to get on the list as well. Typically the athlete has a return to play protocol that they follow with the school’s athletic trainer who then makes the official decision. This is all related to Washinton’s Lystedt Law, making Washington more strict than other states in this regard. I have heard of athletes being referred for physical therapy if they have ongoing headaches, neck pain or balance issues related to the concussion (probably techinicall post concussion syndrome).

My son had PT after his concussion. He worked on trunk and neck strengthening. He is an ice hockey player so we wanted him to be strong for his return to ice. They also worked on static and dynamic balance. I think it depends if the person is returning to a sport. Good luck.

I worked in neuro clinic that specialized in vestibular dysfunction and would see acute concussions for dizziness, ocular motor stabilization, sensory integration, spatial orientation, motor planning, balance. The treatment varied depending on injury, age and deficits.

I get referrals for post concussion syndrome patients. Our doc typically has the person rest and take fish oil, folic acid and I think some B vitamins. He restricts their reading, activity and reduce potential eye strain for a period of time. He sends them to me for treatment of dizziness, head and neck pain. I check and treat for BPPV and for cervicogenic pain/ headaches and dizziness. Our OT treats for cognitive issues.